Endometrial ablation

Endometrial ablation

Endometrial ablation is the intentional destruction of uterine lining to reduce the amount of heavy menstrual bleeding.
It might lead to one of the following:
**decrease menstrual flow
**some stop having menstrual flow at all
The procedure doesn’t need abdominal incisions and that’s why some women might prefer it as a first line to treat their heavy cycles.

What are the indications of endometrial ablation?
** heavy/prolonged cycles that don’t respond to other modalities of treatment
** heavy cycles that affect quality of life
**heavy cycles causing anemia
**bleeding between the cycles

Usually, it is performed for patients who need a hysterectomy but are not suitable candidates for the surgery or don’t want to remove their uterus.

What are the methods of endometrial ablation?
** heated fluid balloon
** radiofrequency energy
** microwave energy
** ablation using very cold temperature
** burning using electrical probe (electrosurgery)

Does endometrial ablation preserve fertility?
No, it should only be done in patients who don’t want future pregnancies
Pregnancy after ablation is very rare and if it happens it might end with bad outcomes such as morbidly adherent placenta

What should be excluded before endometrial ablation?
**Endometrial pathology, as it shouldn’t be done in cases of uterine cancer
**active pelvic infection
**some uterine congenital anomalies

And of course, it shouldn’t be done after menopause as it would be of little value.

What are the possible complications after the procedure?
** pain and cramping
** discharge
** infection
** bleeding
** uterine perforation
** fluid overload with certain methods

Can heavy bleeding return after ablation?
Yes, and it might need further treatment

Dr Najeeb Layyous  F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist